HIV Status Disclosure Laws Under Scrutiny

In more than 30 U.S. states, it's illegal not to inform sexual partners if you're HIV-positive. Here in Iowa, it's a Class B felony that carries up to 25 years in prison, even if there's no transmission of the virus. Proponents say to knowingly expose someone to a potentially lethal virus is equivalent to attempted murder. Critics argue that these laws single out people with HIV to the exclusion of other dangerous STDs, and they hope to see legislation to change the law so it doesn't target those with HIV, many of whom are gay men.

If you live with HIV or AIDS, when do you tell somebody? Give us a call: 800-989-8255. Email us: talk@npr.org. You can also join the conversation at our website. That's at npr.org. Click on TALK OF THE NATION. Lindsey Moon joins us here in the studios of Iowa Public Radio. She's covering the story with IowaWatch, an investigative journalism website. She's also a research assistant here at Iowa Public Radio. Nice of you to have come in today.

LINDSEY MOON, BYLINE: It's great to be here. Thanks.

CONAN: And how prevalent is this statute? How often is it applied?

MOON: Well, since it was put into law in 1988, it's been used 37 - there have been 37 charges filed.

CONAN: Here in Iowa.

MOON: Yeah. Yup - which, according to the best available data, is the second-most number for these laws in the country, second only to Tennessee, which doesn't sound like a big deal, until you step back and consider that Iowa is a low-prevalent state for HIV infection. And so even in states like New York, where there's a lot of people who are infected with HIV, they've only prosecuted four cases for HIV transmission.

CONAN: Now, how did these laws come to be on the books in the first place? They were - you'd think that if somebody is a predator, knowingly does not disclose this and is intent to infecting people, there are laws on the books that cover that already.

MOON: Yeah. Well, they were originally passed in some states because when the Ryan White CARE Act came out to send federal funding the states...

CONAN: This is back in Reagan administration.

MOON: Yeah, right. There - it was included that there had to be a way to - or to prosecute the transmission of HIV. But Iowa's law wasn't passed during that - during those - when those laws were. So Iowa's law was passed in the late '90s, after a case in New York. There was a man named NuShawn Williams who went around and had sex with 75 women and didn't tell him that he was HIV-positive. And so there was a big national media, you know - there's lots of coverage in that case. And so Iowa passed one with a lot of states, because they were worried about something like that happening.

CONAN: So, in fact, has anything like that happened? Has anybody knowingly transmitted the virus?

MOON: No, not from my knowledge or from the reporting that I've done.

CONAN: There are some of these laws also that, as you say, they go back to the Reagan administration. The science is a little bit out of date. There was great concern. This was during the HIV - I'm pretty sure it's fair to call it a panic at those times - that the virus could transmitted by spit or by any number of other transmission methods, which have turned out not to be true.

MOON: Right. I mean, in Iowa's law, one of the problems that advocates say is troublesome with the wording of the law is that it doesn't say whether or not the type of sex act matters, and it also includes any exposure to bodily fluids. So there haven't been many cases prosecuted because of biting or spitting, at least in Iowa, but there have been nationally. And so they just want to have it changed so that it is up to date with public health knowledge.

CONAN: Change - that's an important word. They want a revision of the law, not to take it off the books.

MOON: Right. At least people who are working on it in Iowa are - they just want to change it so that it doesn't just point out people with HIV. And they would like it to...

CONAN: I'll just also say that if it - up to 25 years seems a pretty a stringent penalty if there's no transmission of the virus. And even if, as I understand it, you use protection, you could still be prosecuted under this law.

MOON: Yeah. That is actually one of the big cases that has catapulted it to have a lot of people concerned about how it's being used. There was a case in Waterloo a couple of years ago, and a man - he claims that he did use protection, his partner says that he didn't. He was sentenced to 25 years in prison, which was eventually amended, but at the same time, he was placed on the national sex offender registry. And so it's hard for him to find a job, and he's relocated out of the state because he can't find work here.

CONAN: And that's another aspect of the statute. If you are convicted on this, you were on that sex offender registry, I guess, for the rest of your life.

MOON: Yeah. Yes.

CONAN: And it seems to me you would get - you said somebody said he used protection and the other person said he didn't - you're going to get a lot of he said, he said charges here.

MOON: Yeah. And that's another one of the concerns because there are public health officials who argue that having the he said, he said aspect of it is not OK, especially when there are people pushing to have everyone take their - like personal responsibility for their own sexual health. And one of the men that has a case in litigation, right now, didn't tell his partner. He said that he wanted to use a condom but his partner said no, and he didn't tell him, but if you would have that knowledge, it would have made it different.

But at the same time, if you know that you're in high-risk group, it just - it's one of those things that they would urge you to do anyway. And so, failing to tell someone else of your status, if you're not willing to protect yourself, is one of the problems with the law.

CONAN: And doing some research for this segment, the Centers for Disease Control said that, in fact, knowing transmission of the virus seems to be very rare. Most of the people who are infected are infected, but they didn't know.

MOON: Yeah. That's also true. And it's - there has been one case that's been prosecuted in Iowa where actual transmission did occur. And so when people know that there is a transmission law, they don't get tested, or some people say that they don't get tested for fear that they're going to be prosecuted or that someone could use that against them.

CONAN: Because ignorance of your HIV status is - it gets you out from under the law. If you don't knowingly have HIV, you can't be prosecuted?

MOON: Right. And the only defense that you can use is to say, I had informed consent and here's proof it, so...

CONAN: It gets very complicated. Well, we'd like to hear from those of you in the audience who live with HIV. 800-989-8225. Email us: talk@npr.org. When do you tell somebody? Let's see if we can start first with - this is Tony. And Tony is calling us from Rochester in New York.

TONY: Yes, Neal. Thank you. I've been living with HIV for 18 years, and the person who gave it to me did not tell me, and we ended up being in relationship. He didn't tell me for over a year. And so I tell everyone - immediately. It's - if there's any chance of sexual encounter, I reveal my HIV status. And as I was telling your screener, you know, years ago, it was a deal breaker. You know, people would either say, OK, we have to be safe or we're not going to have sex. A lot of times it was, we're not going to have sex.

But these days with the new developments in medications and so on and so forth and viral load going, you know, way, way down and T cells remaining high and the rate of transmission, even with positive people, I find that it's not a deal breaker anymore.

People will shrug their shoulders and say, OK, no big deal. You know, and if they want to have safe sex, that's fine with me. If it's their choice that we don't, that's fine also. But it's - the culture, at least within the gay community, has certainly changed over the course of, as I said, 18 years.

CONAN: Was there a time when you thought that maybe the person who gave it to you - did it ever cross your mind that, wait a minute, you didn't tell me, that he should be prosecuted?

TONY: Oh, are you kidding? Yes. Yes, it turned into a very dysfunctional relationship because of that. And the relationship ended shortly after he did - well, he didn't reveal. His best friend told me. And then he denied it. And -but, you know, as it came out, it was - yes, I was very angry and very hurt and felt betrayed. And I think that plays a role in why I do tell people. I mean, beside the fact that it's ethically and morally the right thing to do, you know, I had that bad experience of, you know, living intimately with someone who was keeping a huge secret from me.

CONAN: Not only a huge secret, but 18 years ago, this was a lot more serious, as you suggest. It's still pretty serious, but there are a lot advances.

TONY: Exactly. Now it's like considered a manageable condition, sort of like diabetes. But back then, yeah, it was, you know, all of my - I was going to a funeral a week because my friends were dying so quickly of the disease. So, you're absolutely right.

CONAN: Thanks very much for the call. Appreciate it.

TONY: OK. Thank you.

CONAN: Let's see, we go next to - this is Robert. And Robert's on the line with us from Galveston.

ROBERT: Thank you taking the call. I have been HIV positive for many years, and I consider this sort of legislation extremely invasive to people's personal privacy. I agree with the previous caller that it's morally imperative that you share your status with a potential partner. However, these laws are used by people to blackmail HIV-positive people for potential monetary gain. Because, basically, not only are you dealing with sickness issues, but you also have to deal with - you have to be out to your community, to your employer, to your church, to your family, to your friends - so that you're maintaining this outward status so that if anyone comes and tries to compromise your personal privacy, you can maintain that everyone knows that this is basically a known entity. And I really hate this egregious 25-year potential, you know, penalty plus, you know, being on a sex offender registration is just an extreme overreaction from a very limited community that's imposing its will upon people who are already enduring a great burden.

CONAN: Robert, I assume you're talking about the law in Texas. Is up to 25 years here in Iowa, the same in Texas?

ROBERT: No, I actually moved to Texas, away from Louisiana, that has a similar law.

CONAN: And there's not a similar law in Texas?

ROBERT: No.

CONAN: Interesting. Thanks very much for the call.

ROBERT: You're welcome.

CONAN: And I wanted to get back to that point, Lindsey Moon. There are some people who say, you know, again, ignorance of your HIV status gets you out from under this law, even if you do transmit the disease - even if you suspect you have it. If you don't know you have it, and some people say, wait a minute. That prevents some people from being tested.

MOON: Yeah. And I know - I'm not sure if there are many cases where that has been used as an excuse in Iowa, but there is one woman, specifically, that I have spoken with, and she contracted HIV from her husband who didn't know that he was positive. And so, even if she would've wanted to say anything about it and the way that it was transmitted, she couldn't have.

CONAN: Oh, let's see if we can get another caller in on the conversation. We're talking with - I'm actually having a little difficulty with the phone system here. We're talking to Lindsey Moon, a research assistant at Iowa Public Radio, about a law here in Iowa and 33 other states, that makes it a criminal offense to knowingly transmit HIV. You're listening to TALK OF THE NATION from NPR News. And let's go to Jonathan, Jonathan with us from Myrtle Beach.

JONATHAN: Yeah. How are you doing?

CONAN: Good. Thanks.

JONATHAN: I was calling - I'm actually not positive. My husband is, and he disclosed that information to me on our second date. And I think one of the things that is not being addressed in this whole conversation, and I think it's become - because of laws like this, it has become prevalent really to disclose it early on, just because if you're seeking a relationship with somebody, that's something that's going to come out eventually, and you might as well get it out early, rather than late. And rather than investing time in something that's not going to go anywhere, because I think for some people, it really is a deal breaker.

But as your guest alluded to, because of treatments the way they are, especially in the gay community, it's not something that carries the weight that it once carried. It's not something that's as frightening, and it's not a death sentence anymore. I mean, it's something that you'll live with for 20, 30, 50 years. I mean, it's something that is not life-ending.

CONAN: Yes, of course, for most people in most situations, Jonathan. But you never know when somebody's immune system might have been compromised by something else. For somebody else, it might've been...

JONATHAN: Absolutely. And it's something that you just have to be cautious about. I mean, and I think, again, in situations where you are speaking of relationship and you're actually dating somebody, then that's something that you do dispose because you want to make sure that you take those precautionary steps to prevent transmission. I think the real issue here is, in situations, for lack of a better term, where people are hooking up, it's not being disclosed. And though that is not as common as it once was in the gay community, it still does happen. And in those situations, I think a lot of times it's not disclosed because you're not going to achieve the ultimate goal of the hook up, you know?

CONAN: Mm-hmm. I understand. I understand. Thanks very much for the call.

JONATHAN: Thank you.

CONAN: Here's an email. This is from Steven in San Antonio. I'm a gay man living in San Antonio. I've been on medication for five years and have been undetectable since starting. The risk of transmission, even without protection, is very low. However, even today, there is still the stigma that HIV equals a death sentence. When I'm meeting people for dates or whatever, I tell them upfront so - so if they are unable to deal with my status, we don't have to waste any more time. However, there are other STDs that can be just as dangerous and just as deadly as HIV. Those should be included in the laws as well. And, Lindsey Moon, that's one of the situations the proponents of this revision of the law hope to address.

MOON: Yes. With - if the law is revised, they hope to include things like hepatitis. And the draft of this legislation that they have right now mentions things also like maybe typhoid or tuberculosis or - if you're going to prosecute the transmission of a disease, why just limit it to STDs and not, you know, just transmittable diseases, contagious diseases?

CONAN: Let's go next, to Vincent. Vincent's with us from New Lynchburg in Virginia.

VINCENT: Hi. How are you?

CONAN: I'm well. Thank you.

VINCENT: Yeah. What I do is - I've only had to do it once, but since I was diagnosed, I do a full disclosure on the first date. Before we decide to have a relationship and become intimate, I have a letter notarized stating that we have not done anything that would transmit or cause the virus to be transmitted. And we both sign, by the notary, before we even engage in safer sex.

CONAN: Boy, that's romantic, isn't it?

VINCENT: I have to do it to protect my interests.

CONAN: No, I understand, but it could put a damper on things.

VINCENT: Oh, no. Actually, it's kind of exciting because most of the time we go into a local bank, and the bank's - the reaction on the person's face is hilarious.

(SOUNDBITE OF LAUGHTER)

CONAN: That is - OK. Who drew up the letter, by the way?

VINCENT: I drew it up.

CONAN: And it's only - you've only used it once?

VINCENT: Yeah. I only have to use it once.

CONAN: Well, thanks very much, Vincent. Appreciate the phone call. Lindsey Moon, thanks very much for your time today.

MOON: Thank you.

CONAN: Lindsey Moon, a research assistant at Iowa Public Radio. Tomorrow, Jennifer Ludden hosts the show. She'll have Erik Larson on to talk about "In the Garden of Beasts," one of the books we missed when it came out earlier this year. Transcript provided by NPR, Copyright NPR.